title: Adjunctive procedures after pediatric single-stage laryngotracheoplasty.
abstract: OBJECTIVE
  We report the frequency and success rates of adjunctive airway procedures after pediatric single-stage laryngotracheoplasty (LTP) and review different adjunctive techniques in a prospectively enrolled and retrospectively reviewed case series.
  
  
  METHODS
  Of 31 LTP procedures performed from 2008 to 2011 at an academic tertiary care children's hospital, 10 were single-stage LTP procedures. These 10 cases were analyzed to determine the number and type, if any, of adjunctive procedures required after LTP, as well as the subglottic response and decannulation rates.
  
  
  RESULTS
  Of the 10 patients with single-stage LTP procedures, 6 patients required a total of 16 postoperative adjunctive airway procedures. The adjunctive procedures included granulation tissue removal with forceps or a carbon dioxide laser, stent placement, mitomycin C application, and triamcinolone acetonide injection. One patient also required tracheotomy placement and, eventually, cricotracheal resection. All 6 patients had significant improvement of subglottic and/ or tracheal stenosis on their most recent endoscopic examination. With a minimum follow-up of 12 months, all 6 patients were decannulated.
  
  
  CONCLUSIONS
  In this series, more than half of our pediatric patients who underwent single-stage LTP required 1 or more postoperative adjunctive procedures, and all had successful outcomes.
authors.affiliation: Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.
authors.forename: Elena B
authors.initials: EB
authors.lastname: Willis
authors.forename: David
authors.initials: D
authors.lastname: Folk
authors.forename: John P
authors.initials: JP
authors.lastname: Bent
mesh_terms: D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D006097:Granulation Tissue / Q000601:surgery; D006801:Humans; D007829:Laryngostenosis / Q000601:surgery*; D007830:Larynx / Q000601:surgery*; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D015607:Stents; D014132:Trachea / Q000601:surgery*